- Date
- 8/4/2020
- Report number
- 00099742-AP-075732
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide a safe medication administration system
- Result
- Substantiated
- Findings
- Alleged Victim (AV) is care planned for the facility to manage his/her medication. On or about July 31, 2020, the facility received notification that AV's medication would be switching to 50mg tabs instead of 100mg tabs, thus changing dispensing instructions. The new order would not take place until August 8, 2020, when AV's medication would run out. On or about August 4, 2020, AV's physician followed up the pharmacies notification with new dispensing orders to align with the dosage change per tablet. Alleged Perpetrator 2 (AP2) noticed the two orders and thought they were duplicates, so he/she cancelled the second order. This resulted in no medication being refilled. AV went without his/her medication from August 8, 2020 to August 21, 2020. The facility failed to provide a safe medication administration system, which is a violation of resident rights, is neglect of care and constitutes abuse.
- Sanction
- RCFCP21-01864 $225.00 fine assessed